Abstract
BackgroundBuilding on an approach applied to cardiovascular and cancer research, we estimated the economic returns from United Kingdom public- and charitable-funded musculoskeletal disease (MSD) research that arise from the net value of the improved health outcomes in the United Kingdom.MethodsTo calculate the economic returns from MSD-related research in the United Kingdom, we estimated (1) the public and charitable expenditure on MSD-related research in the United Kingdom between 1970 and 2013; (2) the net monetary benefit (NMB), derived from the health benefit in quality adjusted life years (QALYs) valued in monetary terms (using a base-case value of a QALY of £25,000) minus the cost of delivering that benefit, for a prioritised list of interventions from 1994 to 2013; (3) the proportion of NMB attributable to United Kingdom research; and (4) the elapsed time between research funding and health gain. The data collected from these four key elements were used to estimate the internal rate of return (IRR) from MSD-related research investments on health benefits. We analysed the uncertainties in the IRR estimate using a one-way sensitivity analysis.ResultsExpressed in 2013 prices, total expenditure on MSD-related research from 1970 to 2013 was £3.5 billion, and for the period used to estimate the rate of return, 1978-1997, was £1.4 billion. Over the period 1994–2013 the key interventions analysed produced 871,000 QALYs with a NMB of £16 billion, allowing for the net NHS costs resulting from them and valuing a QALY at £25,000. The proportion of benefit attributable to United Kingdom research was 30% and the elapsed time between funding and impact of MSD treatments was 16 years. Our best estimate of the IRR from MSD-related research was 7%, which is similar to the 9% for CVD and 10% for cancer research.ConclusionsOur estimate of the IRR from the net health gain to public and charitable funding of MSD-related research in the United Kingdom is substantial, and justifies the research investments made between 1978 and 1997. We also demonstrated the applicability of the approach previously used in assessing the returns from cardiovascular and cancer research. Inevitably, with a study of this kind, there are a number of important assumptions and caveats that we highlight, and these can inform future research.
Highlights
Building on an approach applied to cardiovascular and cancer research, we estimated the economic returns from United Kingdom public- and charitable-funded musculoskeletal disease (MSD) research that arise from the net value of the improved health outcomes in the United Kingdom
Wellcome Trust (WT) provided further grant descriptions on the proportion of grants which had been classified as less than 50% ‘Musculoskeletal’ to determine whether the grant was within scope of the disease area as defined by ICD 10, and we reduced the total commitment to reflect the proportion of the grant falling under this classification
We present a range of one-way sensitivity analyses that provide an indication of the uncertainty associated with each of the key aggregate parameters that goes into the calculation, namely the size of the research investment, the average elapsed time between research spend and use of the intervention, the magnitude of the net monetary benefit (NMB), the proportion of the NMB that can be attributed to United Kingdom research, and the effect of netting-off royalty payments from the investment stream
Summary
Building on an approach applied to cardiovascular and cancer research, we estimated the economic returns from United Kingdom public- and charitable-funded musculoskeletal disease (MSD) research that arise from the net value of the improved health outcomes in the United Kingdom. Total global investment in biomedical and health research was estimated at US$240 billion in 2009 [1], equivalent to approximately US$270 billion in 2016. These investments are intended to improve health for patients and the public. Researchers and research funders have aimed to better understand the range of impacts arising from public and charitable funding for medical research, including the resulting economic benefits. Such information provides accountability to taxpayers and charity donors, and increases our understanding of how research effectively translates to health gains. This is the third in a series of studies looking at the returns from cardiovascular (CVD) research [2] and cancer research [3], as well as the broader economic impacts or spillover effects of research funding [4]
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